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Accessibility

Disability is defined as any physical or mental impairment which has a substantial and long term (over 12 months) adverse affect on your ability to carry out day to day activities.

Do you consider yourself disabled?

Yes

No

Visual

Hearing

Mobility

Other Physical

Other Medical

Emotional/Behavioural

Mental Ill Health

Temporary Disability

Profound/Complex

Multiple

Other (please specify)

Do you have a learning difficulty?

Yes

No

Moderate learning difficulties

Severe learning difficulties

Dyslexia

Dyscalculia

Other specific learning difficulties

Multiple learning difficulties

Other (please specify)

Do you have an Education, Health & Care Plan (EHCP)? If yes, you will need to send us a copy of your plan.

Yes

No

Criminal Convictions

You must tick 'Yes' if you have a conviction unless it is:

a) A motoring offence that you received a fine or three penalty points for, OR
b) A spent sentence (as defined by the Rehabilitation of Offenders Act 1974)

Please be aware that for certain courses, particularly in teaching, health and social care, you must tell us about ANY criminal conviction(s),
including spent sentences and cautions. If you are serving a prison sentence you must tick the ‘Yes’ box. If you are convicted of a criminal
offence after you have enrolled, you MUST let us know immediately. If you are not sure whether to tell us about a previous conviction you
should get more advice from your Citizens Advice Bureau. In line with the College safeguarding procedure if you declare a conviction we will
need to complete a risk assessment form before we can process the application any further.

How did you hear about HL College and the course(s) for which you are applying?

Please upload your CV (if applicable)

For learners under 18, the College values the support of parents and guardians

Parent 1

Title

Name

Email

Parent 2

Title

Name

Email

Please Note: If you do not wish us to contact them regarding your application, please discuss this at your interview.

Payment of Fees

Payment of course fees must be made in full before a student can be enrolled on to a course. A place on the course will only be confirmed once payment has been received. Please read the Fees Information Sheet before completing this section.

Please choose your method of payment from the options shown below:

I intend to pay by:

Payment by Cheque - Please make cheques payable to 'Herefordshire and Ludlow College' and post to the address shown below, ensuring that you include a covering letter that states your name and chosen course:
Admissions, Herefordshire and Ludlow College, Folly Lane, Hereford, HR1 1LS

Payment by Credit/Debit Card - You can make a Credit/Debit Card payment over the telephone. Please call us on 0800 032 1986 and ask for Admissions.

Payment by Cash - You can come to the Hereford Campus and pay by cash. Please ask for Admissions at Reception.

Company to be invoiced? (company booking only)

Yes

No

If you wish to be invoiced for the course(s) you or your employee are booking onto, please send an email to admissions@hlcollege.ac.uk confirming company name, address, candidate name and that you wish to invoiced for the cost of the course(s). This will confirm your agreement to accept that you are liable for payment on receipt of invoice. Please note, there is no VAT on any of the college’s courses.

Disclaimers

All applicants will be invited for interview. All courses are offered subject to adequate demand.

Under the Data Protection Act of 1998 we need your consent before we can process and store your information. By ticking this box you are consenting to the personal data you supply being used to: (1) Process your application (2) Investigate and provide the correct level of support that may be required by you.

You must agree to this disclaimer before submitting the form.

The information contained on this form will be used to process your application and to keep you informed of courses at HL College. If you do not wish to receive future mailings from us please tick this box.